GP1BA基因多态性与脑梗死急性期患者阿司匹林浓度/剂量的关系

GP1BA Gene Polymorphism and Aspirin Concentration/Dose in Patients with Acute Cerebral Infarctionn

目的探讨脑梗死(CI)急性期患者不同GP1BA基因型与阿司匹林浓度/剂量(C/D)的关系。方法选择2022年6至12月收治的CI急性期患者93例作为研究对象,年龄31~85岁,平均年龄(58.06±7.34)岁。检测GP1BA基因多态性将患者分为:CC基因型组(61例)、CT基因型组(23例)、TT基因型组(9例)。测定3组患者阿司匹林血药浓度并计算C/D比值,对比3组患者一般资料和临床参数,并对比3组患者持续服用阿司匹林1周、2周、1个月、2个月及3个月时的阿司匹林C/D比值。结果3组间的性别、年龄、BMI、糖尿病、高血压病、冠心病、高血脂、吸烟及饮酒史比较,差异均无显著性(均P>0.05);3组间TC、TG、LDL-C、HDL-C、FPG、CRP、WBC及PLT比较,差异均无显著性(均P>0.05);用药1周、2周、1个月、2个月及3个月时间点各GP1BA基因型患者的阿司匹林C/D比值比较差异均有统计学意义(均P<0.05),CC组的阿司匹林C/D比值显著高于CT组和TT组(P<0.05),且CT组与TT组的组间阿司匹林C/D比值比较差异无显著性(P>0.05);CC组治疗总有效率显著低于CT组和TT组(P<0.05),CT、TT基因型患者发生预后不良的风险概率分别为CC基因型的0.038和0.076倍(P<0.05)。结论不同GP1BA基因型显著影响CI急性期患者的阿司匹林C/D比值;CC基因型ACI患者的阿司匹林C/D比值显著高于CT基因型和TT基因型;CC组治疗总有效率显著低于CT组和TT组,且CC组患者预后不良发生率显著高于CT组和TT组;临床阿司匹林的使用应根据患者的自身特点,提供个体化用药方案,提高药物疗效、减少不良反应的发生。

Aim To investigate the relationship between different GP1BA genotypes and aspirin concentration/dose(C/D)in patients with acute cerebral infarction.Methods A total of 93 patients with acute cerebral infarction who were admitted to our hospital from June 2022 to December 2022 were selected as the study objects,ranging in age from 31 to 85 years,with an average age of(58.06±7.34)years.According to the GP1BA gene polymorphism detection,the patients were divided into three groups:a CC genotype group(61 cases),a CT genotype group(23 cases)and a TT genotype group(9 cases).The blood concentration of aspirin in the three groups was measured and the C/D ratio was calculated.The general data and clinical parameters of the three groups were compared,and C/D ratio of aspirin at 1 week,2 weeks,1 month,2 months and 3 months was compared among the three groups.Results There were no significant differences in gender,age,BMI,diabetes,hypertension,coronary heart disease,hyperlipidemia,smoking and drinking among the three groups(P>0.05).There were no significant differences in TC,TG,LDL-C,HDL-C,FPG,CRP,WBC and PLT among the three groups(P>0.05).There were significant differences in aspirin C/D in patients with GP1BA genotype at 1 week,2 weeks,1 month,2 months and 3 months of medication(P<0.05),aspirin C/D in CC group was significantly higher than that in CT and TT groups(P<0.05),and there was no significant difference between CT and TT groups(P>0.05).The total effective rate of treatment in CC group was significantly lower than that in CT group and TT group(P<0.05),and the risk probability of poor prognosis in CT and TT genotype patients was 0.038 and 0.076 times that of CT genotype patients,respectively(P<0.05).Conclusion Different GP1BA genotypes significantly affected aspirin C/D ratio in patients with acute cerebral infarction.The C/D of aspirin in CC genotype patients with cerebral infarction was significantly higher than that in CT genotype and TT genotype patients.The total effective rate in CC group was significantly lower than that in CT group and TT group,and the incidence of adverse prognosis in CC group was significantly higher than that in CT group and TT group.The clinical use of aspirin should be based on the patient's own characteristics,providing a personalized medication plan,improving drug efficacy,and reducing the occurrence of adverse reactions.